RURAL-URBAN DIFFERENCES IN DIGITAL HEALTH USE OF MEDICARE BENEFICIARIES

Abstract Growing reliance on digital healthcare appears to marginalize rural older adults with limited technology access and experience. Existing research explores telehealth uptake of Medicare beneficiaries but does not consider the role of locality in digital health use (DHU). Using the 2021 National Health and Aging Trends Study data, this study compares rural-urban Medicare beneficiaries’ DHU (weighted N=18,729,829). Informed by the Senior Technology Acceptance Model, multiple linear regressions were performed on rural and urban models separately, including DHU, social determinant, and technology readiness variables. Participants in this study were predominantly White, female, and in their 70s. In the final model, men were more likely to use DHU than women in both rural-urban samples (β=.13, β=.08, p<.05, respectively). Tablet access was the only significant device for DHU among rural residents (β=.18, p<.05), while computer access (β=.12, p<.05) was the most significant among urban residents. Online grocery shopping was the most predictive prior technology experience of DHU for rural dwellers (β=.24, p<.05), while online banking led for urban dwellers (β=.21, p<.05). These unique differences between rural-urban samples can inform research on how to specifically design and implement digital interventions to increase rural older adult uptake. Healthcare workers can emphasize similarities between DHU and older adults’ prior technology experience to build perceived ease of use. Expanding opportunities for rural older adults to interact with technology in daily life builds experience which best predicts DHU. Policymakers should consider the impact of locality and involve aging community stakeholders to advance equitable DHU in the digital age.

and develop strategies for effective health system navigation.The research employs a multifaceted approach, combining surveys, focus groups, observational techniques, and interviews to assess the caregiving experience comprehensively.Our primary objectives include evaluating the impact of caregiving burden, socio-emotional support, and health literacy on emergency department visits and hospital admissions for ADRD patients.Preliminary results highlight the significance of culturally sensitive interventions.FA caregivers often encounter difficulties due to cultural beliefs, knowledge gaps about ADRD, and limited support networks.This study outlines the development and testing of a specialized program designed to empower FA caregivers with the skills needed for proficient care management and emergency response.By engaging these caregivers in participatory action research, the program aims to foster active involvement and enhance their caregiving capabilities.The study's outcomes emphasize the potential for improved quality of life and health outcomes for individuals with ADRD and their caregivers.By addressing FA caregivers' unique challenges in the context of disparity populations, our research contributes to enhancing health system navigation behaviors and promoting culturally attuned care practices.This initiative promises to reduce emergency department visits and hospital admissions, benefiting ADRD patients and their dedicated care partners.
Informed by the Senior Technology Acceptance Model, multiple linear regressions were performed on rural and urban models separately, including DHU, social determinant, and technology readiness variables.Participants in this study were predominantly White, female, and in their 70s.In the final model, men were more likely to use DHU than women in both rural-urban samples (β=.13, β=.08, p<.05, respectively).Tablet access was the only significant device for DHU among rural residents (β=.18, p<.05), while computer access (β=.12, p<.05) was the most significant among urban residents.Online grocery shopping was the most predictive prior technology experience of DHU for rural dwellers (β=.24, p<.05), while online banking led for urban dwellers (β=.21, p<.05).These unique differences between rural-urban samples can inform research on how to specifically design and implement digital interventions to increase rural older adult uptake.Healthcare workers can emphasize similarities between DHU and older adults' prior technology experience to build perceived ease of use.Expanding opportunities for rural older adults to interact with technology in daily life builds experience which best predicts DHU.Policymakers should consider the impact of locality and involve aging community stakeholders to advance equitable DHU in the digital age.

LATE BREAKING POSTER SESSION II
Abstract citation ID: igad104.3265

ADAPTING TELEHEALTH EVIDENCED BASED PROTOCOLS FOR VETERANS WITH MOOD AND NEUROCOGNITIVE DISORDERS: A CASE STUDY Charissa Hosseini, Veterans Health Administration, Alameda, California, United States
Aging Veterans with mood and neurocognitive disorders typically have a complex medical and psychiatric presentations leading many providers to exclude them from treatment, expressing that psychotherapy is not appropriate.This form of exclusionary care may decrease help seeking behavior and amplify existing psychological symptoms to an already stigmatized and isolated population.The following case study, outlines a 24-session approach to integrating evidenced based protocols such as Cognitive Behavioral Therapy (CBT) and Narrative Life Review Therapy via telehealth.The presentation will discuss cultural considerations to take when working with Aging Veterans that have co-occurring mood and cognitive difficulties as well as reflect upon the successes and challenges of providing telehealth with this population.
Abstract citation ID: igad104.3266Screening for dementia such as Alzheimer's Disease may be most beneficial at the earliest detectable stages of disease presentation, yet there is no definitive recommendation for routine cognitive impairment screening and dementia remains underdiagnosed.Identifying perceptions of cognitive screening, stigmatized beliefs, and misconceptions about dementia could be beneficial for creating interventions that promote dementia knowledge to improve early screening and diagnosis and empower older adults to seek treatment sooner.Thus, we examined the extent to which attitudes, beliefs, and knowledge about cognitive screening and dementia predict willingness to undergo screening and subsequent screening behavior.295 subjects aged ≥ 60 years completed online surveys containing the Perceptions Regarding Investigational Screening for Memory in Primary Care (PRISM-PC) questionnaire to assess attitudes about dementia screening and diagnosis, as well as the Alzheimer's Disease Knowledge Scale (ADKS).Participants were then invited to complete the Montreal Cognitive Assessment in a university psychology laboratory.94% of participants reported willingness to undergo screening, but only 69% completed one.Logistic regression analysis revealed that the screening acceptance scale of the PRISM-PC significantly predicted reported willingness to undergo screening but not the pursuit of screening.The other PRISM-PC subscales (perceived benefits of dementia screening, stigma of dementia screening, suffering from dementia screening, and impact of dementia screening on patient's independence) and the ADKS did not predict willingness or pursuit of screening.While most were willing to undergo screening, significantly fewer completed screening within the study.The factors that predict pursuit of cognitive screening require further investigation.The present study examined the associations between caregiver assistance, role overload as a stressor, and depression symptoms among caregivers of adults age 65 and older living with and without probable dementia.Specifically, we hypothesized that more time spent caregiving would be associated with higher depressive symptoms via greater role overload and this indirect association would be stronger for those caregiving for an older adult with probable dementia versus no probable dementia.This study analyzed data from round 11 of the National Health and Aging Trends Study (NHATS) and the supplemental National Study of Caregiving (NSOC), which were collected from 2021 through early 2022.The majority of caregivers (207 probable dementia caregivers, 451 no probable dementia caregivers) identified as white (69%), female (70%), and reported an average age of 63.33.A moderated mediation model was tested using the PROCESS Macro (Hayes, 2013) in SPSS.Within our model, dementia classification was found to moderate the effect of the number of days spent caring on role overload (B = .048,SE = .019,t = 2.54, p = .011).Moreover, the overall moderated mediation model was supported with the index of moderated mediation = 0.0094 (95% CI = .0010,.0192).These results indicate that the more days a caregiver spent helping was associated with more symptoms of depression via higher caregiver overload, especially among those caregivers taking